摘要
目的 探讨大型血流贯通式静脉皮瓣的临床疗效.方法 2012年1月至2015年1月对9例上肢皮肤软组织缺损伴动脉缺损的患者,采用大型血流贯通式静脉皮瓣游离移植修复创面,并同时重建缺损动脉,供区以皮片移植修复.皮肤软组织缺损面积7.0 cm×10.0 cm～9.5 cm×18.0 cm,平均9.2 cm ×12.0 cm.皮瓣面积9.0 cm×12.0 cm～11.5 cmu×20.0 cm,平均10.3 cm×13.5 cm.结果 7例皮瓣完全成活,2例皮瓣远端小面积坏死.供区创面植皮均一期愈合.术后随访12～ 26个月,平均14 5个月,皮瓣不臃肿,颜色、质地接近周围正常组织.术后1年,参照英国医学研究会1954年制定的感觉功能评定标准评定皮瓣感觉,S2共2例,S3共4例,S3＋共3例;按中华医学会手外科学会上肢部分功能评定试用标准评定患肢功能,优6例,良2例,差1例.结论 大型血流贯通式静脉皮瓣具有手术简便、供区损伤小、术后外观良好的优点,是修复上肢伴动脉缺损的可行方法.
Objective To investigate the clinical effects of a large flow-through venous flap.Methods Between January 2012 and January 2015,this flap was used in 9 patients with upper limb injury to reconstruct artery defect and large skin and soft tissue defect.The donor sites were covered with free skin grafts.The skin and soft tissue defects size ranged from 7.0 cm × 10.0 cm to 9.5 cm × 18.0 cm （average 9.2 cm× 12.0 cm）.Results The flaps size ranged from 9.0 cm × 12.0 cm-11.5 cm × 20.0 cm （average 10.3 cm × 13.5 cm）.Except 2 cases of small area necrosis occurred in the distal end of the flap,which healed after dressing change;the other 7 flaps survived completely.The donor wounds healed primarily.Postoperative patients were followed up for 12-26 months （mean 14.5 months）.Flap appearance,texture and thickness were similar to the surrounding normal tissue.According to the sensory function evaluation standard formulated by the British Medical Research Council in 1954,the result of skin flap sensory evaluation was assessed as S2 in two cases,S3 in four cases,S3 in three cases,with excellent and good rate as 77.8%.According to the assessment standard for upper limb function issued by Chinese Medical Association of hand surgery,the limb function were assessed as excellent in 6 cases,good in 2 cases,poor in 1 case,with the excellent and good rate as 88.9%.Conclusions The large flowthrough venous flap has the advantages of simple operation,minimal donor site morbidity and satisfactory appearance.It is a feasible method to repair the wound at upper limb with artery defect.
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2016年第4期249-253,共5页
Chinese Journal of Plastic Surgery
基金
江苏省徐州市医学青年后备人才培养工程基金（2014018）
关键词
静脉皮瓣
软组织损伤
上肢
Venous skin flap
Soft tissue injuries
Upper extremity
